Kindercare forms: Update Your Child Care Enrollment Agreement

Childcare Transportation Request Form

Childcare requests MUST be resubmitted every school year before August 12.

School
Choose SchoolAchievable DreamBT WashingtonCarverCharlesCrittendenDeer ParkDenbigh ECCDenbigh HSDiscovery STEM AcademyDutrowFitzgerald MSEnterprise AcademyGatewoodGeneral StanfordGildersleeve MSGreenwoodHeritage HSHidenwoodHiltonHinesHuntingtonJenkinsJohnsonKiln CreekKnollwood MeadowsMenchville HSMECCMarshallMcintoshNewsome ParkPalmerPassageRichneckRiversideSanfordSaundersSedgefieldStoney RunWarwick HSWatkinsWatkins ECCWoodside HSYates

Grade
Choose Grade010203040506070809101112PK – ECC OnlyPKA – ECC OnlyPKP – ECC OnlyKG – KindergartenPP – SPED OnlyPPA – SPED OnlyPPP – SPED Only

Student Name

Student ID Number
Student ID must be 6 characters. If you do not know the student ID number, please enter 000000.

Your Email Address
This email address will be used to communicate with you. You will only receive a response if childcare transportation is denied or if a new bus stop is created.

Comments (max 500 characters)

Verify childcare address with Zonefinder (out-of-zone requests will be denied).

Choose from these common providers (optional) OR enter the childcare name and address below.
Choose ProviderAmandas Development Amazing World Daycare Antioch Christian Center Arms of the King – 10998 Jefferson Barnes Family Childcare Beginnings Academy of Learning Boys and Girls Club (Tayler Ave) Boys and Girls Club (Tyler Ave) Boys Club Hampton Avenue Boys Club Mid-Town Boys Club Uptown Bright Heights C Waldo Scott Calvary Chapel Children of the Kingdom Children Of The Village Bellwood Rd Colonial Childcare Denbigh Christian Academy Denbigh Community Center Doris Miller Eagles Nest Learning Center (Downtown Jefferson) Eagles Nest Childcare (Morris Dr. ) EXET Center First Baptist Church Denbigh Fort Eustis Child Development Center ECC ONLY Fort Eustis Child Development Center grades KG_05 Fort Eustis Youth Center Garden of Children Gethsemane Baptist – Roanoke Girls Inc – Adams Dr Heavenly Haven Childcare – Warwick Holy Tabernacle Christian In Coretta’s Care In Touch Afterschool Joyful Horizons Daycare Kiddy City Kids Comfort Zone (Oyster Point) Kindercare Sierra Dr Midtown Community Center NWS Childcare Center Parks and Rec (Before and/or After School) – Specify Riverside Childcare Stepping Stone Childcare – Jefferson Stepping Stone Childcare – Pilot House Stepping Stone Childcare – Warwick Tots Around the Clock True Heart Child Care Warwick Kids Academy Warwick Reformation Church Daycare Warwick River Christian School We Love Kids Wee Care Daycare YMCA Warwick Blvd

Childcare Name

Childcare Address
Out-of-zone address will be denied.

Childcare Phone Number

Requested Start Date

Choose one:

To and From School

To School

From School

Is this request for summer school?

Yes

No

Forms & Documents | Washington State Department of Children, Youth, and Families

Child care licensing fees are suspended until June 30, 2023; however, due to recently passed legislation, effective July 1, 2023, child care fees will be required.

Applications

You must attend orientation before submitting a licensing application.

Family Home or Child Care Center Application

• DCYF #15-955 Family Home and Center Child Care License or Certification Application

School-Age Application

• DCYF #15-980 School-Age Child Care License or Certification Application

Capacity Increase/Change Planning Form

• DCYF #15-874 Capacity Increase Change Planning Guide
• Capacity Chart Home
• Center Mixed Ages Capacity Chart
• Center No Mixed Ages Capacity Chart
• School-Age Programs Capacity Chart
• Family Home 13+ Capacity Waiver Capacity and Ratio Chart

Child Care Agreement

• DCYF #15-943 Child Care Agreement

Child Care Health Consultant Agreement

• DCYF #15-966 Child Care Health Consultant Agreement

Child Care Health Consultant On-Site Report

• DCYF #15-967 Child Care Health Consultant Onsite Report

Child Care Registration Form

• DCYF #15-879 Child Care Registration

Child Injury/Incident Report

WAC 110-300-0475 requires family home providers and child care center providers to use this DCYF form when reporting certain injuries and incidents to the department. School-age providers may use this form, but WAC 110-305 does not require the use of it.

• DCYF #15-941 Child Care Injury Incident Report

Chimney, Fireplace, Woodstove Use Statement

• DCYF #15-891 Chimney, Fireplace, Woodstove Use Statement

Daily Attendance Records

• DCYF #15-942 Daily Child Attendance Records

Family Home/Child Care Center – Feasibility Checklist

• DCYF #15-963 Family Home/Center Feasibility Checklist

Family Home Liability Insurance Notice

• DCYF #15-894 Family Home Child Care Liability Insurance Form

Fire Safety

Fire Safety & Emergency Drills Form

WAC 110-300-0470(4) requires family home providers and child care center providers to use this DCYF form. School-age providers may use this form, but WAC 110-305 does not require use of this specific form.

• DCYF #15-892 Fire, Safety, Emergency Drills Record

Annual Fire Inspection – State Fire Marshal Form

WAC 110-300-0170 requires a family home provider and a child care center provider to arrange for a fire safety inspection annually.   WAC 110-301-0170 requires a school-age provider to arrange a fire safety inspection annually. If a local government agency is not available to conduct a fire safety inspection, the provider must inspect for fire safety using the State Fire Marshal form.

• Family Home Fire Inspection Form
• Child Care Center/School-Age Program Fire Inspection Form

Immunizations

Certificate of Immunization Status Form

• English | Spanish | Somali

Certificate of Exemption

• English | Spanish | Somali

Individual Care Plan & Food Allergy Forms

• DCYF #15-970 Individual Care Plan for Child in Child Care

Initial Checklists for Applicants

• DCYF # 15-861 Initial Checklist for Child Care Center Applicant
• DCYF # 15-862 Initial Checklist for Family Home Child Care Applicant
• DCYF # 15-863 Initial Checklist for School-Age Program Applicant

Intent to Transfer License or Certification

• DCYF #15-853 Intent to Transfer Child Care License or Certification

Medication Log

• DCYF # 15-969 Child Care Medication Log

Medication Authorization Form

• DCYF #15-968 Child Care Medication Authorization

Monitoring Checklists (Example)

• DCYF # 15-708 Child Care Center Monitoring Checklist (Example)
• DCYF # 15-709 Family Home Child Care Monitoring Checklist (Example)
• DCYF # 15-707 School-Age Child Care Monitoring Checklist (Example) 

No Social Security Card Declaration Form

• DCYF #15-956 No Social Security Card Declaration

Notification and Staffing Plan for Absence

• DCYF #15-954 Notification of Staffing Plan Absence

Overnight Child Care Planning Form

• DCYF #15-895 Overnight Child Care Planning Form

Parental Notification Letters

Notice of Safe Sleep Non Compliance PDF

• DCYF #15-952 Notification to Parents and Guardian – Safe Sleep Non-Compliance

Probation Notification Letter

• DCYF #15-896 Probation Notification Letter

Parent-Guardian Permission Form

• DCYF #15-897 Child Care Parent Guardian Permissions         

Provider Portal Support (contact info)

• DCYF #LIC_0005 Provider Portal Support

Sanitizer or Disinfectant Approval Request

• DCYF #15-965 Sanitizer Disinfectant Approval Request

School-Age Program – Feasibility Checklist

• DCYF #15-964 School-Age Feasibility Checklist

School-Based and Military Certification for Payment-Only Request Form

• English: Word | PDF

Tribal Certification Request Letter

• DCYF #15-945 Tribal Certification Request

Water Safety

• Testing for Lead and Copper in Child Care Facilities
• Safe Water Sources Tip Sheet

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